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·综合疾病·

挤压脐带对改善新生儿预后的影响研究*

作者:刘晓燕 刁诗光 邱建武

所属单位:汕头大学医学院附属粤北人民医院新生儿科 (广东 韶关 512026)

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摘要

目的 探讨挤压脐带对改善新生儿预后的影响。方法 选取我院从2015年1月到2016年1月我院产科出生的600例新生 儿作为研究对象。按照出生顺序随机分为干预组300例与对照组300例,干预组新生儿应用挤压脐带方法进行干预, 对照组新生儿应用常规生后立即结扎脐带方法。对比两组新生儿的血红蛋白、红细胞比积、血清总胆红素,新生儿 血压、出生后低血压的发生、扩容药物使用情况、新生儿红细胞增多症、颅内出血、坏死性小肠结肠炎、早产儿 视网膜病变、脑白质软化的发生率及新生儿死亡率。结果 干预组新生儿血红蛋白、红细胞比积显著高于对照组新 生儿,差异具统计学意义(P<0.05)。干预组新生儿低血压发生率及扩容药物使用率低于对照组新生儿,差异具统 计学意义(P<0.05)。干预组新生儿颅内出血发生率、坏死性小肠结膜炎、脑白质软化及死亡率均低于对照组新生 儿,差异具统计学意义(P<0.05)。结论 对新生儿应用挤压脐带干预措施,显著提高新生儿出生后的血红蛋白水 平,降低婴幼儿贫血,减少新生儿出生后低血压和颅内出血的发生几率。

Objective To explore the effect of umbilical cord milking (UCM) on the prognosis of neonates. Methods 600 cases of neonate from January 2015 to May 2016 in our hospital were selected as the research object, which were randomly divided into 300 cases of intervention group and 300 cases of control group according to birth order. The intervention group were underwent UCM, and the control group were underwent immediate cord clamping after be born. The method of squeezing umbilical cord was applied to intervene the newborns in intervention group, the conventional method of immediate ligation of umbilical cord after birth was applied to the newborns in control group. The two groups of newborn were compared with each other in terms of hemoglobin, hCT, serum total bilirubin, newborn blood pressure, occurrence of hypotension after birth, medication of dilatation, polycythemia of newborn, intracranial hemorrhage, necrotizing enterocolitis, retinopathy of premature infant, incidence of leucomalacia and mortality of newborn. Results The hemoglobin, hCT of newborn in intervention group were significantly higher than that of the ones in control group, the inter-group difference was significant (P<0.05), the occurrence of hypotension after birth and usage rate of medication of dilatation of newborn in intervention group were significantly lower than that of the ones in control group, the inter-group difference was significant (P<0.05), the incidence of intracranial hemorrhage, necrotizing enterocolitis, leucomalacia and mortality of newborn in intervention group were equally significantly lower than that of the ones in control group, the inter-group difference was significant (P<0.05). Conclusion The application of method of squeezing umbilical cord to intervene the newborns can clearly enhance the level of hemoglobin of newborn after birth, diminish the anemia of infant, and reduce the incidence of hypotension and intracranial hemorrhage of newborn after birth.

【关键词】挤压脐带;新生儿;预后

【中图分类号】R722.12

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.03.018

前言

新生儿出生时采取立即结扎脐带(immediate cord clamping, ICC)其贫血发生率大大增加,而新 生儿贫血可影响脑部供氧,缺氧后影响新生儿智力发 育,如何降低贫血发生率改善新生儿预后是目前学术 界研究的重点[1]。我院从2015年1月开始研究挤压脐带干预措施对改善新生儿预后的影响,现报道如下。